Kinolon ilişkili nadir bir komplikasyon: Uzun QT sendromu

Öz

Enfekte diyabetik ayak ülserlerinin tedavisinde antibiyotikler sık kullanılan tedavi ajanları arasında yer almaktadır. Ancak antibiyotiklere bağlı bazen hayatı tehdit edebilecek boyutta ciddi yan etkiler görülebilir. Bu yazıda enfekte diyabetik ayak ülseri nedeniyle kinolon grubu antibiyotik tedavisi başlanan bir hastada bu tedaviyi takiben gelişen uzun QT sendromu ve devamında kardiyopulmoner arrest gelişen ve defibrilasyon tedavisi ile reanimasyonu sağlanan oldukça nadir bir vaka tartışılarak nadir görülen komplikasyon üzerine dikkat çekmeyi amaçladık.  

Anahtar Kelimeler

• uzun QT sendromu,antibiyotik,kinolon

Quinolone-associated a rare complication: Long QT syndrome

Öz

In the treatment of infected diabetic foot ulcers, antibiotics are frequently used as treatment agents. However, serious adverse effects may be seen on antibiotics, which can sometimes be life-threatening. In this article, we aimed to draw attention to a rare complication in a patientwhowastreatedwithquinoloneantibioticsduetoinfecteddiabeticfootulcer, a rare long QT syndrome following this treatment, subsequent cardiopulmonary arrest  and reanimation with defibrillation therapy.  

Anahtar Kelimeler

• Long QT syndrome,antibiotic,quinolone

Kaynakça

1. 1. Moss AJ. Long QT syndrome. JAMA 2003; 289: 2041-44.
2. 2. Vincet GM. Themoleculargenetic of thelong QT syndrome: Genes causing fainting and sudden death. Annu Rev Med 1998; 49: 263-74.
3. 3. Vincent GM. Long QT syndrome. Cardiology Clinics 2000; 18: 309-25.
4. 4. Roden DM. Takingthe ‘idio’ out of ‘idiosyncratic’. Predicting torsades de pointes. Pacing Clin Electrophysiol 1998; 21: 1029-34.
5. 5. Donger C, Denjoy I, Berthet M et al. KVLQT1 C terminal missense mutation causes a forme fruste long QT syndrome. Circulation 1997; 96: 2778-81.
6. 6. Wang WX, Ebert SN, Liu XK et al. "Conventional" antihistamines slow cardiac repolarization in isolated perfused (Langendorff) feline hearts. J Cardiovasc Pharmacol 1998; 32: 123-28.
7. 7. Reardon M, Malik M. QT interval change with age in an overtly healthy older population. Clin Cardiol1996; 19: 94952.
8. 8. Fogarty C, Grossman C, Williams J et al. Efficacy and safety of moxifloxacin vs. clarithromycin for community-acquiredpneumonia. Infect Med 1999; 16: 748 – 63.

9. 9. Korvick J. QT and quinolones: recent regulatory actions. Office of Drug Evaluation IV. Division of Special Pathogens FDA 5/23/01.
10. 10. Noel GJ, Natarajan J, Chien S et al. Effects of three fluoroquinolones on QT interval in healthy adults after single doses. Clin Pharmacol Ther 2003; 73: 292 – 303.
11. 11. Stahlmann R, Schwabe R. Safetyprofile of grepafloxacin compared with other fluoroquinolones. J Antimicrob Chemother 1997; 40: 83 – 92.
12. 12. Owens RC Jr, Ambrose PG. Clinical use of the fluoroquinolones. Med Clin North Am 2000; 84: 1447 – 96.
13. 13. Appelbaum PC, Hunter PA. The fluoroquinolone antibacterials: Past, present and future perspectives. Int J Antimicrob Agents 2000; 16: 5 – 15.
14. 14. Stahlman R, Lode H. Toxicity of quinolones. Drugs 1999; 58: 37 – 42.
15. 15. Bertino J, Fish D The safety profile of the fluoroquinolones Clin Ther 2000; 22: 798 – 817.
16. 16. Ball P. Future of the quinolones. Semin Respir Infect 2001; 16: 215 – 24.